﻿<?xml version="1.0" encoding="utf-8"?>
<!--268 Annuity Activity-->
<TransactionSpecification TransactionSetIdentifierCode="268" xmlns="http://tempuri.org/X12ParserSpecification.xsd">
  <Segment SegmentId="BGN" Usage="Required" Repeat="1" />
  <Segment SegmentId="C3" Repeat="1" />
  <Segment SegmentId="DTP" Repeat="9" />
  <Loop LoopId="NM1" LoopRepeat="2">
    <Name>Individual or Organizational Name</Name>
    <StartingSegment SegmentId="NM1" />
    <Segment SegmentId="N3" Repeat="3" />
    <Segment SegmentId="N4" Repeat="1" />
    <Segment SegmentId="REF" Repeat="9" />
    <Segment SegmentId="PER" Repeat="3" />
  </Loop>
  <Loop LoopId="N1">
    <Name>Name</Name>
    <StartingSegment SegmentId="N1" />
    <Segment SegmentId="N2" Repeat="3" />
    <Segment SegmentId="N3" Repeat="3" />
    <Segment SegmentId="N4" Repeat="1" />
    <Segment SegmentId="REF" Repeat="9" />
    <Segment SegmentId="DTP" />
    <Loop LoopId="PID">
      <Name>Product/Item Description</Name>
      <StartingSegment SegmentId="PID" />
      <Segment SegmentId="SPA" Repeat="3" />
      <Segment SegmentId="LIN" Repeat="9" />
      <Segment SegmentId="III" Repeat="9" />
    </Loop>
    <Loop LoopId="PO1">
      <Name>Baseline Item Data</Name>
      <StartingSegment SegmentId="PO1" />
      <Segment SegmentId="SPA" Repeat="3" />
      <Segment SegmentId="AMT" Repeat="3" />
      <Segment SegmentId="III" Repeat="9" />
    </Loop>
    <Loop LoopId="ACT">
      <Name>Account Identification</Name>
      <StartingSegment SegmentId="ACT" />
      <Segment SegmentId="N3" Repeat="3" />
      <Segment SegmentId="N4" Repeat="1" />
      <Segment SegmentId="SPA" Repeat="3" />
      <Segment SegmentId="DTP" Repeat="9" />
      <Segment SegmentId="LIN" Repeat="9" />
      <Segment SegmentId="PAM" Repeat="9" />
      <Segment SegmentId="III" Repeat="9" />
    </Loop>
    <Loop LoopId="CON">
      <Name>Contract Number Detail</Name>
      <StartingSegment SegmentId="CON" />
      <Segment SegmentId="REF" Repeat="9" />
      <Segment SegmentId="LIN" Repeat="9" />
      <Segment SegmentId="DTP" Repeat="9" />
      <Segment SegmentId="SPA" Repeat="3" />
      <Segment SegmentId="AMT" />
      <Segment SegmentId="PAM" Repeat="9" />
      <Loop LoopId="NM1">
        <Name>Individual or Organizational Name</Name>
        <StartingSegment SegmentId="NM1" />
        <Segment SegmentId="N3" Repeat="3" />
        <Segment SegmentId="N4" Repeat="1" />
        <Segment SegmentId="REF" Repeat="9" />
        <Segment SegmentId="DMG" Repeat="1" />
        <Segment SegmentId="BEN" Repeat="9" />
        <Segment SegmentId="DTP" Repeat="9" />
        <Segment SegmentId="ASI" Repeat="1" />
      </Loop>
      <Loop LoopId="BLI">
        <Name>Baseline Item Data</Name>
        <StartingSegment SegmentId="BLI" />
        <Segment SegmentId="LIN" Repeat="3" />
        <Segment SegmentId="SPA" Repeat="3" />
        <Segment SegmentId="DTP" Repeat="9" />
        <Segment SegmentId="AM1" Repeat="9" />
      </Loop>
      <Loop LoopId="IT1">
        <Name>Baseline Item Data (Invoice)</Name>
        <StartingSegment SegmentId="IT1" />
        <Segment SegmentId="REF" Repeat="1" />
        <Segment SegmentId="DTP" Repeat="9" />
        <Segment SegmentId="AM1" Repeat="99" />
        <Segment SegmentId="SPA" Repeat="3" />
        <Segment SegmentId="MSG" Repeat="9" />
        <Loop LoopId="ACT">
          <Name>Account Identification</Name>
          <StartingSegment SegmentId="ACT" />
          <Segment SegmentId="LIN" Repeat="9" />
          <Segment SegmentId="SPA" Repeat="3" />
          <Segment SegmentId="AM1" Repeat="9" />
          <Segment SegmentId="DTP" Repeat="9" />
          <Segment SegmentId="MSG" Repeat="9" />
        </Loop>
        <Loop LoopId="NM1">
          <Name>Individual or Organizational Name</Name>
          <StartingSegment SegmentId="NM1" />
          <Segment SegmentId="SPA" Repeat="3" />
          <Segment SegmentId="G86" Repeat="1" />
          <Loop LoopId="EFI">
            <Name>Electronic Format Identification</Name>
            <StartingSegment SegmentId="EFI" />
            <Segment SegmentId="BIN" Repeat="1" />
          </Loop>
        </Loop>
      </Loop>
      <Loop LoopId="LX" LoopRepeat="">
        <Name>Assigned Number</Name>
        <StartingSegment SegmentId="LX" />
        <Segment SegmentId="AM1" Usage="Required" Repeat="1" />
        <Segment SegmentId="DTP" Repeat="9" />
        <Loop LoopId="RPA">
          <Name>Rate Amounts or Percents</Name>
          <StartingSegment SegmentId="RPA" />
          <Segment SegmentId="DTP" Repeat="3" />
          <Loop LoopId="AMT">
            <Name>Monetary Amount</Name>
            <StartingSegment SegmentId="AMT" />
            <Segment SegmentId="REF" Repeat="9" />
          </Loop>
        </Loop>
      </Loop>
    </Loop>
  </Loop>
</TransactionSpecification>